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目的:探讨高龄老人血浆尿酸水平对2型糖尿病（T2DM）发病风险的影响。方法:资料来自老年健康生物标志物队列研究（HABCS），该项目于2008—2009年开展基线调查，于2011—2012年、2014年和2017—2018年进行了3次随访，共2 213名≥80岁高龄老人被纳入本研究。收集对象人口学特征、生活方式和患病情况等资料，并对其进行体格测量，收集空腹静脉血进行尿酸和血糖检测。追踪随访对象糖尿病发病、死亡结局情况。采用 Cox比例风险回归模型探索高尿酸血症和血浆尿酸水平对T2DM发病的影响，采用限制性立方样条（RCS）函数来探索血浆尿酸水平与T2DM发病风险之间的剂量反应关系。结果:研究对象年龄为（93.2±7.6）岁，女性占66.7%（1 475名）。基线调查时血浆尿酸水平为（289.1 ±88.0）μmol/L，高尿酸血症患病率为13.3%（294例）。9年累积随访7 471人年（人均随访3.38年），T2DM新发病例122例，发病密度为1 632.98/10万人年。Cox比例风险回归分析结果显示，血浆尿酸水平每升高10 μmol/L，T2DM发病风险增加1.1% ［n HR（95%n CI）：1.011（1.004，1.017）］。与处于血浆尿酸最低五分位数（n Q1）者相比，最高五分位数（n Q5）高龄老人T2DM发病风险增加20.7 % ［n HR（95%n CI）：1.207（1.029，1.416）］。与血浆尿酸正常者相比，高尿酸血症者T2DM发病风险增加19.2% ［n HR（95%n CI）：1.192（1.033，1.377）］。RCS函数显示，随着血浆尿酸水平升高，糖尿病发病风险增加，呈非线性剂量反应关系（n P=0.016）。n 结论:随着血浆尿酸水平升高高龄老人T2DM发病风险增加。“,”Objective:To investigate the effect of plasma uric acid level on the incident risk of type 2 diabetes mellitus (T2DM) among the oldest old (those aged ≥80 years).Methods:Participants were recruited from the Healthy Aging and Biomarkers Cohort Study (HABCS), which conducted a baseline survey in 2008-2009 and follow-up of 3 times in 2011-2012, 2014, and 2017-2018, respectively. A total of 2 213 oldest old were enrolled in this study. The general demographic, socioeconomic, lifestyle and disease data of the oldest old were collected, and physical measurements were made for the oldest old. Fasting venous blood was collected for uric acid and blood glucose detection. Information on the incident and death of T2DM were collected through the follow-up. Cox proportional hazard regression model was used to explore the association of hyperuricemia and plasma uric acid level with the incidence of T2DM. Restricted cubic spline (RCS) function was used to explore the dose-response relationship of plasma uric acid levels with the risk of T2DM.Results:The age of participants was (93.2±7.6) years old, and 66.7% of the participants (1 475) were female. The plasma uric acid level at baseline was (289.1±88.0)μmol/L, and the prevalence of hyperuricemia was 13.3% (294 cases). During 9 years of cumulative follow-up of 7 471 person-years (average of 3.38 years for each), 122 new cases of T2DM occurred and the incidence density was 1 632.98/10n 5 person year. Cox proportional hazards regression analysis showed that per 10μmol/L increase in plasma uric acid level, the risk of T2DM increased by 1.1% [n HR (95%n CI): 1.011 (1.004, 1.017)]. Compared with the participants with the lowest quintile of plasma uric acid (n Q1), the risk of diabetes increased by 20.7 % among the oldest old with uric acid in the highest quintile (n Q5) [n HR (95%n CI):1.207 (1.029, 1.416)]. The risk of T2DM was 19.2% higher in the hyperuricemia group than that in the oldest old with normal plasma uric acid [n HR (95%n CI): 1.192 (1.033, 1.377)]. RCS function showed that the risk of T2DM increased with the increase in plasma uric acid levels in a nonlinear dose-response relationship (n P=0.016).n Conclusion:The incident risk of T2DM increases with the elevates of plasma uric acid levels in the oldest old.